肺结核患者Toll样受体基因的表达及意义

The role of Toll-like receptors in pulmonary tuberculosis

目的探讨肺结核患者Toll样受体(TLRs)基因及其产物表达的特征并分析吸烟对TLRs基因表达的影响,为肺结核病的辅助诊断、鉴别诊断及免疫治疗提供理论依据。方法选择肺结核患者31例(其中吸烟8例,未吸烟23例)作为患者组及29例健康体检者作为对照组,利用Real time RT-PCR和ELISA方法检测两组人群TLR2、TLR3、TLR4、TLR8 mRNA相对表达量和TLR2、TLR3、TLR4、TLR8血清浓度。结果 (1)患者组TLR2、TLR4、TLR8 mRNA△Ct值显著低于对照组,而TLR3 mRNA△Ct值则显著高于对照组(均P<0.01)。患者组与对照组TLR2、TLR3、TLR4、TLR8 mRNA相对表达倍数变化分别为:8.40、-13.64、2.11、2.83。患者组TLR2、TLR4、TLR8 mRNA相对表达量显著高于对照组,呈现上调表达,而患者组TLR3 mRNA相对表达量则显著低于对照组,呈现下调表达。(2)两组人群TLR2、TLR3、TLR4、TLR8血清浓度差异存在显著性,患者组显著高于对照组(均P<0.01)。(3)患者组中吸烟者与未吸烟者TLR2、TLR3、TLR4、TLR8血清浓度差异均无显著性(均P>0.05),TLR2、TLR3、TLR4、TLR8 mRNA相对表达量差异也无显著性(均P>0.05)。结论 TLR2、TLR4、TLR8 mRNA表达水平是肺结核病诊断的敏感性指标之一,TLR2、TLR4、TLR8 mRNA表达水平和TLR2、TLR3、TLR4、TLR8血清浓度可以作为菌阴肺结核诊断与鉴别诊断的辅助指标。

Objective To probe the expression characteristics of Toll - like receptors （TLRs） in the patients with pulmonary tuberculosis, and to analyze the effects of smoking on gene expression of TLRs, so as to provide a theoretical basis for the auxiliary diagnosis, differential diagnosis and immunotherapy of pulmonary tuberculosis. Methods Thirty - one patients with pulmonary tuberculosis （8 smokers and 23 non- smokers） and 29 healthy subjects （controls） were en- rolled. The mRNA expression levels of TLR2, TLR3, TLR4, and TLR8, and the serum concentrations of TLR2, TLR3, TLR4, and TLR8 were assessed by Real time RT- PCR and ELISA techniques, respectively. Results The A Ct values of TLR2, TLR4, TLR8 mRNA in the patients were significantly lower than those in the controls, while the ACt value of TLR3 mRNA was significantly higher than those in the controls （ all P 〈 0. 01 ）. The relative expression fold of TLR2, TLR3, TLR4, and TLR8 mRNA between the patients and the controls were 8. 40, - 13. 64, 2. 11, and 2. 83, respectively; with significant difference between them. There were significant elevations in the serum concentrations of TLR2, TLR3, TLR4 and TLR8 of the patients （ all P 〈 0. 01 ）. There was no significant difference in serum concentrations or mR- NA expression of TLR2, TLR3, TLR4, or TLR8 between the smokers and non - smokers in the patients. Conclusion TLR2, TLR4, and TLR8 mRNAs are sensitive indicators for diagnosis of pulmonary tuberculosis, and the mRNA levels and serum concentrations of TLR2, TLR4 and TLR8 can be used as the supplementary indicators in diagnosis and differential diagnosis of pulmonary tuberculosis with smear negative.